Volume 9 • 2022 • Issue 2

First published in 1977, the Model List of Essential Medicines contains medications considered to be most effective in responding to the priority needs of global populations. The list only contains medicines that treat diseases with high prevalence and public health relevance. An expert committee reviews the list regularly, which is updated every two years. All medications included must be efficient, safe and cost effective. effects. The applications must show a convincing cost versus benefit analysis. “Sodium fluoride was previously listed, but it was kind of hidden and nobody used it for promoting fluoride or increasing availability,” says Dr. Benzian. Now that a specific formulation of fluoride toothpaste is on the list, he hopes that it will be made more available and affordable in countries where it is often too expensive for average citizens. He says that it is possible that some other methods of fluoride delivery may be included on the WHO list in the future, such as varnish or mouth rinses. “Glass ionomer cement is an alternative to dental amalgam, the use of which is being phased down globally as a result of the Minamata Convention,” says Dr. Benzian. Finding an alternative to amalgam is a challenge for many countries’ health care systems, because filling materials are expensive or require expensive equipment. “Glass ionomer cement is easy to place, has decent longevity and has the benefit of releasing fluoride over time,” he says. Dr. Benzian says that the oral health benefits of SDF have a long history but they have been recognized more in the last few years. “Fairly recently, the American Dental Association released non-invasive, non-restorative treatment guidelines for caries, which recommends SDF as the first line of treatment,” he says. When asked if other dental preparations might be added to the list in the future, Dr. Benzian says that, aside from different fluoride products, it is unlikely because most preparations used in dentistry are medical products rather than medications. “However, there are certain medications, such as antibiotics, where oral health indications may be listed in the future in addition to the existing indications,” he says. “The items on the list are highly cost-effective products that are options for prevention and treatment of tooth decay,” says Dr. Benzian. “Having dental preparations on the list will have tangible positive consequences in many places in the world. The idea is that a medication that is on the list should be universally available in a functioning health care system, at all times,” says Dr. Benzian. The list has significant impact in lower-income countries where resources are scarce; 137 nations have medicine lists based on the WHO model list. The inclusion of three dental preparations is also intended to increase the availability and quality of the preparations in low- and middle-income countries; their prices may decline; and greater use among the population should improve public health outcomes. “It will hopefully lower prices because medications on the list are often eligible for tax exemptions or tax reductions as well as the removal of trade tariffs,” says Dr. Benzian. Dr. Benzian explains that to be included in the list, an application must be made to the WHO. “The application contains evidence, including a review of the scientific literature that shows that the medicine is effective, safe and without alternatives,” he says. “It also includes an overview of availability in different countries, trade rights, local regulations of indications and contraindications, and side The inclusion of three dental preparations is also intended to increase the availability and quality of the preparations in low- and middle-income countries; their prices may decline; and greater use among the population should improve public health outcomes. Watch an interview with Dr. Benzian on CDA Oasis: bit.ly/33rHbQw 22 | 2022 | Issue 2 News and Events